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Malnutrition in pediatric patients with cancer at diagnosis and throughout therapy: A multicenter cohort study
Author(s) -
Zimmermann Karin,
Ammann Roland A.,
Kuehni Claudia E.,
De Geest Sabina,
Cignacco Eva
Publication year - 2013
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24409
Subject(s) - medicine , malnutrition , interquartile range , pediatrics , cohort , cancer , body mass index , pediatric cancer , incidence (geometry) , retrospective cohort study , cohort study , physics , optics
Background Malnutrition is a common problem in pediatric patients with cancer. Reported prevalence varies widely and has often been assessed only in a subset of childhood types of cancer. This study aimed to describe the prevalence of malnutrition among pediatric patients newly diagnosed with cancer, to describe the occurrence and course of malnutrition during therapy and to identify factors associated with malnutrition during therapy. Procedure In a retrospective cohort study of 327 patients diagnosed from 2003 to 2006 in three Swiss tertiary care hospitals, weight and height measures together with patient‐, disease‐, and treatment‐related characteristics were assessed. Malnutrition was defined as body mass index (BMI) below −2 standard deviation scores (SDS) or a weight loss >10% from diagnosis. Malnutrition was assessed at diagnosis and continuously during anticancer therapy. Results At diagnosis, 5.8% of the patients (19) were malnourished based on BMI. During anticancer therapy, the cumulative incidence of malnutrition rose to 22% (70 patients) after 30 days, to 36% (116 patients) after 60 days, and finally to 47% (155 patients). In these 155 patients, the median duration of malnutrition was 60 days (interquartile range, 21–122). Age above 10 years at diagnosis, BMI ≤ −1.0 SDS at diagnosis, and a diagnosis of medulloblastoma were positively associated with a higher proportion of malnutrition time during therapy. Conclusions The rapid increase of malnutrition after the start of treatment underlines the need to develop evidence‐based and efficient methods to provide nutritional support for children with cancer. Pediatr Blood Cancer 2013; 60: 642–649. © 2012 Wiley Periodicals, Inc.